scholarly journals The Impact of Social Role Identity on Communication in Hospital-Based Antimicrobial Stewardship

2021 ◽  
Vol 1 (S1) ◽  
pp. s14-s14
Author(s):  
Julia Szymczak ◽  
Brandi Muller ◽  
Nikitha Shakamuri ◽  
Keith Hamilton ◽  
Elizabeth Dodds Ashley ◽  
...  
Keyword(s):  
Social Identity ◽  
Antimicrobial Stewardship ◽  
Role Theory ◽  
Social Role ◽  
The United States ◽  
Role Identity ◽  
Clinical Team ◽  
Face To Face ◽  
Group Orientation ◽  
The Impact

Background: Evidence-based hospital antimicrobial stewardship interventions, such as postprescription review with feedback, prior authorization, and handshake stewardship, involve communication between stewards and frontline prescribers. Hierarchy, asymmetric responsibility, prescribing etiquette, and autonomy can obstruct high-quality communication in stewardship. Little is known about the strategies that stewards use to overcome these barriers. The objective of this study was to identify how stewards navigate communication challenges when interacting with prescribers. Methods: We conducted semistructured interviews with antimicrobial stewards recruited from hospitals across the United States. Interviews were audio recorded, transcribed, and analyzed using a flexible coding approach and the framework method. Social identity theory and role theory were used to interpret framework matrices. Results: Interviews were conducted with 58 antimicrobial stewards (25 physicians and 33 pharmacists) from 10 hospitals (4 academic medical centers, 4 community hospitals, and 2 children’s hospitals). Respondents who felt empowered in their interactions with prescribers explicitly adopted a social identity that conceptualized stewards and prescribers as being on the “same team” with shared goals (in-group orientation). Drawing on the meaning conferred via this social role identity, respondents engaged in communication strategies to build and maintain common bonds with prescribers. These strategies included moderating language to minimize defensive recommendations when delivering stewardship recommendations, aligning the goals of stewardship with the goals of the clinical team, communicating with prescribers about things other than stewardship, compromising for the sake of future interactions, and engaging in strategic face-to-face interaction. Respondents who felt less empowered in their interactions thought of themselves as outsiders to the clinical team and experienced a heightened sense of “us versus them” mentality with the perception that stewards primarily serve a gate-keeping function (ie, outgroup orientation). These respondents expressed deference to hierarchy, a reluctance to engage in face-to-face interaction, a feeling of cynicism about the impact of stewardship, and a sense of low professional accomplishment within the role. Respondents who exhibited an in-group orientation were more likely than those who did not to describe the positive impact of stewardship mentors or colleagues on their social role identity. Conclusions: The way antimicrobial stewards perceive their role and identity within the social context of their healthcare organization influences how they approach communication with prescribers. Social role identity in stewardship is shaped by the influence of mentors and colleagues, indicating the importance of supportive relationships for the development of steward skill and confidence.Funding: NoDisclosures: None

Use of a Structured Panel Process to Define Quality Metrics for Antimicrobial Stewardship Programs

2012 ◽  
Vol 33 (5) ◽  
pp. 500-506 ◽  
Author(s):  
Andrew M. Morris ◽  
Stacey Brener ◽  
Linda Dresser ◽  
Nick Daneman ◽  
Timothy H. Dellit ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antimicrobial Stewardship ◽  
Bloodstream Infections ◽  
The United States ◽  
Community Acquired Pneumonia ◽  
Public Reporting ◽  
Modified Delphi ◽  
Number Of Patients ◽  
Days Of Therapy ◽  
The Impact

Introduction.Antimicrobial stewardship programs are being implemented in health care to reduce inappropriate antimicrobial use, adverse events, Clostridium difficile infection, and antimicrobial resistance. There is no standardized approach to evaluate the impact of these programs.Objective.To use a structured panel process to define quality improvement metrics for evaluating antimicrobial stewardship programs in hospital settings that also have the potential to be used as part of public reporting efforts.Design.A multiphase modified Delphi technique.Setting.Paper-based survey supplemented with a 1-day consensus meeting.Participants.A 10-member expert panel from Canada and the United States was assembled to evaluate indicators for relevance, effectiveness, and the potential to aid quality improvement efforts.Results.There were a total of 5 final metrics selected by the panel: (1) days of therapy per 1000 patient-days; (2) number of patients with specific organisms that are drug resistant; (3) mortality related to antimicrobial-resistant organisms; (4) conservable days of therapy among patients with community-acquired pneumonia (CAP), skin and soft-tissue infections (SSTI), or sepsis and bloodstream infections (BSI); and (5) unplanned hospital readmission within 30 days after discharge from the hospital in which the most responsible diagnosis was one of CAP, SSTI, sepsis or BSI. The first and second indicators were also identified as useful for accountability purposes, such as public reporting.Conclusion.We have successfully identified 2 measures for public reporting purposes and 5 measures that can be used internally in healthcare settings as quality indicators. These indicators can be implemented across diverse healthcare systems to enable ongoing evaluation of antimicrobial stewardship programs and complement efforts for improved patient safety.

Gender and Volunteering at the Special Olympics: Interrelationships Among Motivations, Commitment, and Social Capital

2020 ◽  
Vol 34 (1) ◽  
pp. 77-90
Author(s):  
Kirstin Hallmann ◽  
Anita Zehrer ◽  
Sheranne Fairley ◽  
Lea Rossi
Keyword(s):  
Gender Differences ◽  
Social Capital ◽  
Personal Growth ◽  
Structural Equation ◽  
Role Theory ◽  
Social Role ◽  
Equation Modeling ◽  
Special Olympics ◽  
Market Opportunities ◽  
The Impact

This research uses social role theory to investigate gender differences in volunteers at the Special Olympics and interrelationships among motivations, commitment, and social capital. Volunteers at the 2014 National Summer Special Olympics in Germany were surveyed (n = 891). Multigroup structural equation modeling has revealed gender differences among motivations, commitment, and social capital. Volunteers primarily volunteered for personal growth. Further, motivations had a significant association with commitment and social capital. The impact of motivation on social capital was significantly mediated by commitment. Event organizers should market opportunities to volunteer by emphasizing opportunities for personal growth and appealing to specific values.

scholarly journals Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic

2020 ◽  
Author(s):  
Meghan K Berkenstock ◽  
Paulina Liberman ◽  
Peter J McDonnell ◽  
Benjamin C Chaon
Keyword(s):  
Practice Patterns ◽  
Low Vision ◽  
The United States ◽  
Viral Transmission ◽  
Pediatric Ophthalmology ◽  
Face To Face ◽  
Diagnostic Codes ◽  
Before And After ◽  
Icd 10 ◽  
The Impact

Abstract BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face to face encounters to only patients with urgent and emergent ophthalmic conditions, in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the six weeks before and after the changes in clinical practice associated with COVID-19.RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest total decrease of in-person visits. Conversely, the number of telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.

scholarly journals Does it Matter Where IT Workers are Located?

10.1068/c0646 ◽  
2007 ◽  
Vol 25 (5) ◽  
pp. 709-728 ◽  
Author(s):  
Elsie Echeverri-Carroll ◽  
Sofia G Ayala ◽  
Mayuresh Kshetramade ◽  
Priyanka Murthy
Keyword(s):  
The United States ◽  
Spatial Proximity ◽  
Human Communication ◽  
Face To Face ◽  
Two Factors ◽  
It Workers ◽  
Using Data ◽  
Us Census ◽  
The Impact ◽  
College Educated

The predominant view in the literature is that cities affect labor productivity because spatial proximity facilitates the transfer of ideas which make workers more productive. We also anticipate that information technology, or IT (both equipment and labor), by facilitating human communication and speeding up the flow of ideas and data, also contributes to enhancing the productivity of workers within cities. Thus, workers will be more productive in cities with a large endowment of these two factors of production. The objective of this paper is twofold. First, it describes the spatial characteristics of IT workers in the United States. Second, it tests the hypothesis that in cities with a higher endowment of IT workers wages (a proxy for productivity) would be higher after controlling for the characteristics of individual workers and city-specific characteristics that also affect wages. Using data from the 2000 US Census of Population (5% PUMS), we find evidence of a wage premium, especially for college-educated workers, associated with living in a city that has a large concentration of IT workers. On the basis of our findings, we propose to move the discussion on the future of cities from the effect of IT equipment on face-to-face communication to the impact on cities of losing IT workers.

scholarly journals 2004. Impact of Procalcitonin Roll-out Without Antimicrobial Stewardship Guidance in a Community Hospital Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S672-S672
Author(s):  
Alfredo J Mena Lora ◽  
Samah Qasmieh ◽  
Eric Wenzler ◽  
Scott Borgetti ◽  
Naman Jhaveri ◽  
...  
Keyword(s):  
United States ◽  
Emergency Department ◽  
Length Of Stay ◽  
Antimicrobial Stewardship ◽  
Community Hospital ◽  
The United States ◽  
Healthcare Research ◽  
Antimicrobial Use ◽  
Tract Infections ◽  
The Impact

Abstract Background Lower respiratory tract infections (LRTIs) are one of the most common infectious disease-related emergency department (ED) visits in the United States. The ID Society of America and the Agency for Healthcare Research and Quality support the use of procalcitonin (PCT) for antimicrobial stewardship (ASP) in LRTI. Though not widely available, awareness and access to PCT is rising. At our facility, PCT became available in February 2018. The aim of our study is to assess the impact of PCT at an urban community hospital and identify possible targets for ASP interventions. Methods Retrospective review of cases from February to August 2018. Cases from the ED were selected for review. Appropriateness of testing was assessed, defined as guideline-based use for cessation of antibiotics in uncomplicated LRTIs without critical illness or immunosuppression. Demographic variables and clinical characteristics, such as, diagnosis, antimicrobial use and PCT levels were obtained. Results PCT was ordered 268 times hospital-wide, of which 160 (60%) were in the ED. Ages ranged from 0–90, with an average of 47. Most cases were male (51%). Appropriate testing for LRTI occurred in 33 (29%) cases. Antimicrobials were used in 75% of cases with low (< 0.5) PCT levels (Figure 1). Length of stay (LOS) was higher in groups that received antimicrobials (Figure 2). Testing was not appropriate in 127 cases (71%), with upper respiratory (21%), soft-tissue (17%), genitourinary (15%) and abdominal (13%) infections as the most common reasons for testing. Other diagnosis included alcohol withdrawal, seizures and altered mental status. Cumulative cost of PCT testing was $24000, of which $19050 was not consistent with guidelines. Conclusion Clinicians routinely ordered PCT in the ED. Antimicrobials were used for LRTIs despite low PCT levels. This may have contributed to higher LOS and excess antimicrobial use. Unwarranted PCT testing had a cost of $19050. As PCT becomes widely available in hospitals across the United States, education and decision support by ASP to clinicians may be needed to enhance guideline-appropriate evidence-based use of PCT. Targeted ASP interventions in the ED may have cost savings by reducing excess testing, length of stay and improving antimicrobial use. Disclosures All authors: No reported disclosures.

scholarly journals Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic

2020 ◽  
Author(s):  
Meghan K Berkenstock ◽  
Paulina Liberman ◽  
Peter J McDonnell ◽  
Benjamin C Chaon
Keyword(s):  
Practice Patterns ◽  
Low Vision ◽  
The United States ◽  
Viral Transmission ◽  
Pediatric Ophthalmology ◽  
Face To Face ◽  
Diagnostic Codes ◽  
Before And After ◽  
Icd 10 ◽  
The Impact

Abstract BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face to face encounters to only patients with urgent and emergent ophthalmic conditions, in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the six weeks before and after the changes in clinical practice associated with COVID-19.RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest decrease of in-person visits. Conversely, telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.

scholarly journals The Impact of the Covid-19 Pandemic on Retail Consumer Behavior

2021 ◽  
Vol 5 (1) ◽  
pp. 79-88
Author(s):  
Sayyida Sayyida ◽  
Sri Hartini ◽  
Sri Gunawan ◽  
Syarief Nur Husin
Keyword(s):  
Consumer Behavior ◽  
Quantitative Methods ◽  
Online Shopping ◽  
Secondary Data ◽  
The United States ◽  
Marketing Strategies ◽  
Retail Sales ◽  
Face To Face ◽  
Secondary Data Sources ◽  
The Impact

The COVID-19 pandemic that occurred throughout 2020 has an impact on economic sector. Consumers tend to use online channels to reduce face-to-face contact with marketers or other consumers. On the other hand, the consumer's need to see, touch and feel a product directly is only available in physical stores. This study aims to analyze the impact of the COVID-19 pandemic on retail consumer behavior. This study uses quantitative methods with secondary data sources obtained from several countries including the United States, England, Germany, France, Canada and Latin America. The results show that the shopping trends during the COVID-19 pandemic are webrooming and pure online shopping. Retail sales data in these countries shows that retail sales in physical stores exceed 70% of total retail sales and retail e-commerce sales are less than 30% of total retail sales. This research is expected to be useful for marketers in improving retail marketing strategies during the COVID-19 pandemic

scholarly journals ‘Unfreezing’ traditional teaching

2021 ◽  
Vol 3 (1) ◽  
pp. 17-18
Author(s):  
Philippa Smith ◽  
Helen Sissons
Keyword(s):  
Learning Experience ◽  
Health Impact ◽  
The United States ◽  
Virtual Classroom ◽  
Educational Systems ◽  
Face To Face ◽  
The Government ◽  
Sudden Transition ◽  
University Lecturers ◽  
The Impact

Teaching online is not an unfamiliar phenomenon for university lecturers evidenced by the rapid rise in the number of those who “want to teach online”, “have been told to teach online” and “are training and encouraging others to teach online” (Ko & Rossen, 2017:xx). Never-the-less, the impact of the Coronavirus pandemic in 2020 caught many teachers from elementary to tertiary level unprepared and in some cases led to the collapse of educational systems in countries around the world (Mishra, Gupta & Shree, 2020).   Moving lessons online, creating virtual classrooms, accessing appropriate software and online tools, as well as being competent in the use of them within a very short time period not only required “adjustment” but also had a “mental health impact” on both the educators and the students (Etchells et al, 2020). Attempts have been made to assess the success with which lecturers have been able to transition their classes to online. A survey of students in the United States (USC Center for the Digital Future, 2020), for example, asked about their remote learning experience during the pandemic and found that only around one-third enjoyed it better than in-class instruction. In addition, almost one half of them felt they learned less online than in person, and only around half of the students believed that their teachers were good at adapting their courses for online construction. This raises the question of whether educational institutions and their staff were up to speed enough with online learning to make this sudden transition.   For those running practical teaching programmes that require face-to-face contact, the thrust into the isolation of Covid-19 lock-down was most challenging. This presentation documents our learning experiences as two Auckland University of Technology lecturers whose respective programmes involving journalism practice and student collaborative movie-making were caught midway by lockdown when the government commanded us to “Stay Home, Save Lives”. Viewing our teaching experiences through the lens of change management theory (Lewin, 1958) that divides the process of change into the three stages of unfreezing – changing– refreezing, we discuss how the unfreezing of our standard methods of instruction forced us into change where we had no other choice but to learn to adapt our courses and teach online. We provide insights in this presentation as to how well the new methods of the virtual classroom worked for us based on the resources we were given, and whether they are now refrozen and maintained in our classes for the future, or will we simply change back to our original methods. We also offer feedback from the students and their experiences of our lessons in lockdown.    

scholarly journals WHO IS A PROPER SOLDIER? ANALYSIS OF A MODERN MILITARY IDENTITY

2019 ◽  
Vol 2019, 21/4 (Volume 2019/issue 21/4) ◽  
pp. 15-26
Author(s):  
GARB MAJA
Keyword(s):  
Social Identity ◽  
Social Identity Theory ◽  
Role Theory ◽  
Social Role ◽  
Multiple Identities ◽  
Social Identities ◽  
Social Role Theory ◽  
The Past ◽  
Categorization Theory ◽  
Military Members

Abstract Social identity theory forms one of the key theories in social psychology and sociology. However, some other theories, such as self-categorization theory and social role theory are also used to explain the relations among individuals and groups. In the past the identities were assigned, whereas nowadays people explore their identities themselves; they have multiple identities and they can self-categorize themselves. Modern militaries and their members experience similar changes. Traditional military identity is characterized by stabilized relations, manifesting mainly through hierarchical structure and established discipline, and subordination of personal identity to the collective one. Modern military identity is not uniform and unambiguous. Military members, in addition to their military identity and military roles, develop other social identities and enact a variety of different social roles. Key words Social identity, social role, military identity, traditional military identity, modern military identity.

scholarly journals Hands in medicine: understanding the impact of competency-based education on the formation of medical students’ identities in the United States

2016 ◽  
Vol 13 ◽  
pp. 31 ◽  
Author(s):  
Catherine Gonsalves ◽  
Zareen Zaidi
Keyword(s):  
United States ◽  
Medical Students ◽  
Identity Formation ◽  
Social Role ◽  
Clinical Skills ◽  
Core Competencies ◽  
The United States ◽  
Competency Based Education ◽  
Competency Based ◽  
The Impact

Purpose: There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on ‘doing the work of a physician’ rather than identity formation and ‘being a physician.’ This study aims to understand how competency-based education impacts the development of a medical student’s identity. Methods: Three ceramic models representing three core competencies ‘medical knowledge,’ ‘patient care,’ and ‘professionalism’ were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes. Results: Students across all four years of medical school related to the ‘professionalism’ competency domain (50%). They reflected that ‘being an empathetic physician’ was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized ‘professionalism’ as a competency. Conclusion: Students perceive ‘professionalism’ as a competency that impacts their identity formation in the social role of ‘being a doctor,’ albeit a competency they are less likely to be assessed on. High-stakes exams, including the United States Medical Licensing Exam clinical skills exam, promote this perception.

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